Morbidity with arterial hypertension among workers involved in nuclear weaponry utilization

View or download the full article: 
PDF icon health-risk-analysis-2019-4-10.pdf
UDC: 
61
DOI: 
10.21668/health.risk/2019.4.10.eng
Authors: 

K.V. Briks, M.V. Bannikova, T.V. Azizova, G.V. Zhuntova, E.S. Grigor'eva

Organization: 

The Southern Urals Biophysics Institute of the RF Federal Medical and Biological Agency, 19 Ozerskoe drive, Ozersk, 456780, Russian Federation

Abstract: 

Cardiovascular diseases remain a basic socially significant issue in most countries all over the world. Our research goal was to comparatively assess morbidity with arterial hypertension (ICD-9 codes 401–404 or ICD-10 codes I.10 –I.14) among workers involved in nuclear weaponry utilization. We examined an occupational cohort that included workers employed at chemical-metallurgical production of “Mayak” Production Association (PA). They were all employed in 1949–2014 and observed by medical personnel up to December 31, 2017; overall, the cohort included 10,908 people. We analyzed morbidity parameters taking into account both radiation factors (external gamma-irradiation and internal alpha-irradiation caused by incorporated plutonium) and basic non-radiation ones. Standardization was accomplished indirectly with an internal standard. Morbidity was calculated with medical statistics tools per 1,000 workers. We also assessed excess relative risk per one dose (ERR/Gy). As a result, we revealed that on December 31, 2017 2,270 arterial hypertension cases were registered in the examined cohort that included workers employed at “Mayak” PA who were involved in utilizing nuclear weaponry. We showed that standardized morbidity with arterial hypertension among workers employed at “Mayak” PA and involved in utilizing nuclear weaponry statistically significantly depended on non-radiation factors (sex, age, smoking status, attitude towards alcohol intake, body mass index, and pancreatic diabetes) and didn’t depend on total dose of external gamma-irradiation and internal alpha-irradiation absorbed in the liver.

Keywords: 
arterial hypertension, morbidity, external gamma-irradiation, internal alpha-irradiation, occupational irradiation, cohort study, “Mayak” PA, nuclear weaponry utilization
Briks K.V., Bannikova M.V., Azizova T.V., Zhuntova G.V., Grigor'eva E.S. Morbidity with arterial hypertension among workers involved in nuclear weaponry utilization. Health Risk Analysis, 2019, no. 4, pp. 93–103. DOI: 10.21668/health.risk/2019.4.10.eng
References: 
  1. Wilkins E., Wilson L., Wickramasinghe K., Bhatnagar P., Leal J., Luengo-Fernandez R., Burns R., Rayner M., Townsend N. European Cardiovascular Disease Statistics 2017. Brussels: European Heart Network, 2017. Available at: http://www.ehnheart.org/images/CVD-statistics-report-August-2017.pdf (04.06.2019).
  2. Belov V.B., Rogovina A.G. The basic medical demographic indicators of population health of Russia up to 2013. Problemy sotsial'noi gigieny, zdravookhraneniya i istorii meditsiny, 2014, vol. 22, no. 6, pp. 18–22 (in Russian).
  3. Russian statistical yearbook. Moscow, Rosstat Publ., 2017, 686 p. Available at: http://www.gks.ru/free_doc/doc_2017/year/year17.pdf (04.06.2019) (in Russian).
  4. Shal'nova S.A., Deev A.D. Russian mortality trends in the early XXI century: official statistics data. Kardiovaskulyarnaya terapiya i profilaktika, 2011, vol. 10, no. 6, pp. 5–10 (in Russian).
  5. Oganov R.G., Maslennikova G.Ya. Demographic trends in the Russian Federation: the impact of cardiovascular disease. Kardiovaskulyarnaya terapiya i profilaktika, 2012, vol. 11, no. 2, pp. 5–10 (in Russian).
  6. Chow C.K., Teo K.K., Rangarajan S., Islam S., Gupta R., Avezum A., Bahonar A., Chifamba J. [et al.]. PURE (Prospective Urban Rural Epidemiology) Study investigators. Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle, and low-income countries. JAMA, 2013, vol. 310, no. 9, pp. 959–968 (in Russian). DOI: 10.1001/jama.2013.184182
  7. Rahimi K., Emdin C.A., MacMahon S. The epidemiology of blood pressure and its worldwide management. Circulation research, 2015, vol. 116, no. 6, pp. 925–936. DOI: 10.1161/CIRCRESAHA.116.304723
  8. Chazova I.E., Oshchepkova E.V. Results of the Federal (National) Project for prevention and treatment essential hypertension patients in Russia from 2002–2012 years. Vestnik Rossiiskoi akademii meditsinskikh nauk, 2013, vol. 68, no. 2, pp. 4–11 (in Russian).
  9. Koshurnikova N.A., Shilnikova N.S., Okatenko P.V., Kreslov V.V., Bolotnikova M.G., Sokolnikov M.E., Khokhriakov V.F., Suslova K.G. [et al.]. Characteristics of the cohort of workers at the Mayak nuclear complex. Radiation Research, 1999, vol. 152, no. 4, pp. 352–363. DOI: 10.2307/3580220
  10. Merkov A.M., Polyakov L.E. Sanitarnaya statistika (posobie dlya vrachei) [Sanitary statistics (manual for physicians)]. Moscow, Atomizdat Publ., 1975, 384 p. (in Russian).
  11. Zar J.H. Biostatistical Analysis. New Jersey, Prentice Hall Publ., 1999, 718 p.
  12. Yoon S.S., Fryar C.D., Carroll M.D. Hypertension prevalence and control among adults: United States, 2011–2014. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statis-tics, 2015, no. 220, pp. 1–8.
  13. Mozaffarian D., Benjamin E.J., Go A.S., Arnett D.K., Blaha M.J., Cushman M., Das S.R., De Ferranti S. [et al.]. Heart disease and stroke statistics-2016 update a report from the American Heart Association. Circulation, 2016, vol. 133, no. 4, pp. 38–48. DOI: 10.1161/CIR.0000000000000366
  14. Di Pilla M., Bruno R.M., Taddei S., Virdis A. Gender differences in the relationships between psychosocial factors and hypertension. Maturitas, 2016, no. 93, pp. 58–64. DOI: 10.1016/j.maturitas.2016.06.003
  15. Smetnik V.P., Smetnik A.A. Female sex hormones and cardiovascular system. Meditsinskii sovet, 2011, no. 3–4, pp. 40–45 (in Russian).
  16. Yureneva S.V., Mychka V.B., Ilyina L.M., Tolstov S.N. Cardiovascular risk factors in women and the role of sex hormones. Kardiovaskulyarnaya terapiya i profilaktika, 2011, vol. 10, no. 4, pp. 128–135 (in Russian).
  17. Belenkov Yu.N., Fomin I.V., Badin Yu.V. Gendernye razlichiya v rasprostranennosti i effektivnosti lecheniya arteri-al'noi gipertenzii v Evropeiskoi chasti Rossiiskoi Federatsii: rezul'taty issledovaniya EPOKhA-2007 [Gender-related differences in prevalence and efficiency of arterial hypertension treatment in the European part of the Russian Federation: results of EPOKHA-2007 research]. Problemy zhenskogo zdorovya, 2011, vol. 6, no. 4, pp. 5–11 (in Russian).
  18. Oganov R.G., Maslennikova G.Ya. Gender specifics of cardiovascular pathology. Kardiovaskulyarnaya terapiya i profilaktika, 2012, vol. 11, no. 4, pp. 101–104 (in Russian).
  19. Oganov R.G., Timofeeva T.N., Koltunov I.E., Konstantinov V.V., BalanovaYu.A., Kapustina A.V., Lelchuk I.N., Shalnova S.A., Deev A.D. Arterial hypertension epidemiology in Russia; the results of 2003–2010 federal monitoring. Kardio-vaskulyarnaya terapiya i profilaktika, 2011, vol. 10, no. 1, pp. 9–13 (in Russian).
  20. Staessen J.A., Ginocchio G., Thijs L., Fagard R. Conventional and ambulatory blood pressure and menopause in a prospective population study. Journal of human hypertension, 1997, vol. 11, no. 8, pp. 507–514. DOI: 10.1038/sj.jhh.1000476
  21. Wassertheil-Smoller S., Anderson G., Psaty B.M., Black H.R., Manson J., Wong N., Francis J., Grimm R. [et al.]. Hypertension and its treatment in postmenopausal women: baseline data from Women’s Health Initiative. Hypertension, 2000, vol. 36, no. 5, pp. 780–789. DOI: 10.1161/01.hyp.36.5.780
  22. Belyakov N.A., Seidova G.B., Dorofeev V.I., Zheltisheva G.A. Mechanisms of postmenopausal endothelial dysfunc-tion. Problemy zhenskogo zdorovya, vol. 2, no. 4, pp. 54–60 (in Russian).
  23. Balanova Yu.A., Shal`nova S.A., Deev A.D., Konstantinov V.V., Kapustina A.V. Arterial hypertension among men and women in Moscow. Arterial'naya gipertenziya, 2013, vol. 19, no. 2, pp. 102–108 (in Russian).
  24. Efremova Yu.E., Oshchepkova E.V., Zhernakova Yu.V., Chazova I.E., Yarovaya E.B., Shal'nova S.A., Rotar' O.P., Konradi A.O. [et al.]. Cardiovascular risk factors in people with high normal blood pressure in Russian population (based on data obtained in ESSE-RF epidemiological study). Sistemnye gipertenzii, 2017, vol. 14, no. 1, pp. 6–11 (in Russian).
  25. Barbarash O.L., Karetnikova V.N., Kochergina A.M., Indukaeva E.V., Artamonova G.V. Cardiovascular risk factors and its association with target blood pressure level in reachment in patients with arterial hypertension in Kemerovo. Meditsina v Kuzbasse, 2016, vol. 15, no. 1, pp. 47–53 (in Russian).
  26. Drapkina O.M. Smoking and related problems in the practice of a cardiologist. Arterial'naya gipertenziya, 2010, vol. 16, no. 2, pp. 164–169 (in Russian).
  27. Chazova I.E., Zhernakova Yu.V., Oshchepkova E.V., Shal'nova S.A., Yarovaya E.B., Konradi A.O., Boitsov S.A. Prevalence of Cardiovascular Risk Factors in Russian Population of Patients With Arterial Hypertension. Kardiologiya, 2014, vol. 54, no. 10, pp. 4–12 (in Russian).
  28. Balanova Iu.A., Kontsevaia A.V., Shal'nova S.A., Deev A.D., Artamonova G.V., Gatagonova T.M., Dupliakov D.V., Efanov A.Yu. [et al.]. Prevalence of behavioral risk factors for cardiovascular disease in the Russian population: Results of the ESSE-RF epidemiological study. Profilakticheskaya meditsina, 2014, vol. 17, no. 5, pp. 42–52 (in Russian).
  29. Efanov A. Yu., Storozhok M.A., Sholomov I.F., Medvedeva I.V., Shalaev S.V. Prevalence of cardiovascular risk fac-tors in nonorganized population of 25-64 year olds in Tyumen region. Results of ESSE-RF study in Tyumen region. Kardiovas-kulyarnaya terapiya i profilaktika, 2016, vol. 15, no. 4, pp. 60–65 (in Russian). DOI: 10.15829/1728-8800-2016-4-60-65
  30. Maksimov S.A., Indukaeva E.V., Skripchenko A.E., Cherkass N.V., Pavlova S.V., Artamonova G.V. Prevalence of major factors of cardiovascular risk in Kemerovo region: results of multicenter epidemiological research «ESSE-RF». Meditsina v Kusbasse, 2014, vol. 13, no. 3, pp. 36–42 (in Russian).
  31. Muromtseva G.A., Kontsevaya A.V., Konstantinov V.V., Artamonova G.V., Gatagonova T.M., Duplyakov D.V., EfanovA.Yu., ZhernakovaYu.V. [et al.]. The prevalence of non-infectious diseases risk factors in Russian population in 2012–2013 years. The results of «ESSE-RF». Kardiovaskulyarnaya terapiya i profilaktika, 2014, vol. 13, no. 6, pp. 4–11 (in Russian). DOI: 10.15829/1728-8800-2014-6-4-11
  32. Maksimov S.A., Danilchenko Ya.V., Tabakaev M.V., Mulerova T.A., Indukaeva E.V., Artamonova G.V. The relation of alcohol consumption with cardiovascular diseases and risk factors («ESSE-RF» trial in Kemerovskaya oblast`). Rossiiskii kardiologicheskii zhurnal, 2017, vol. 22, no. 9, pp. 65–70 (in Russian). DOI: 10.15829/1560-4071-2017-9-65-70
  33. Poteshkina N.G., Krylova N.S., Adzhigaitkanova S.K., Troshina A.A. Alcohol in prevention of cardiovascular pa-thology: known and unknown. Rossiiskii kardiologicheskii zhurnal, 2015, vol. 20, no. 6, pp. 100–105 (in Russian). DOI: 10.15829/1560-4071-2015-06-100-105
  34. Maksimov S.A., Tsygankova D.P., Artamonova G.V. Frequency of cardiovascular risk factors in relation to the vol-umes of alcohol consumption (the ESSE-RF study in the Kemerovo Region). Profilakticheskaya meditsina, 2017, vol. 20, no. 6, pp. 91–96 (in Russian). DOI: 10.17116/profmed201720691-96
  35. Mogensen C.E. New treatment guidelines for a patient with diabetes and hypertension. J. Hypertens. Suppl., 2003, vol. 21, no. 1, pp. 25–30.
  36. Haffner S.M., Lehto S., Ronnemaa T., Pyörälä K., Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N. Engl. J. Med., 1998, vol. 339, no. 4, pp. 229–234. DOI: 10.1056/NEJM199807233390404
  37. Vaidya V., Gangan N., Sheehan J. Impact of cardiovascular complications among patients with type 2 diabetes mellitus: a systematic review. Expert Rev. Pharmacoecon Outcomes Res., 2015, vol. 15, no. 3, pp. 487–497. DOI: 10.1586/14737167.2015.1024661
  38. Dedov I.I., Shestakova M.V. Sakharnyi diabet i arterial'naya gipertenziya [Pancreatic diabetes and arterial hypertension]. Moscow, MIA Publ., 2006, 344 p. (in Russian).
  39. Sarwar N., Gao P., Seshasai S.R. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet, 2010, vol. 9733, no. 375, pp. 2215–2222. DOI: 10.1016/S0140-6736(10)60484-9
  40. Sur G., Sur M., Kudor-Szabadi L., Sur L., Sporis D., Sur D. Arterial hypertension – prevalence of risk factors and morbide associations that increase cardiovascular risk. Maedica (Buchar), 2010, vol. 5, no. 1, pp. 34–40.
  41. Haslam D.W., James W.P. Obesity. Lancet, 2005, vol. 366, no. 9492, pp. 1197–1209. DOI: 10.1016/S0140-6736(05)67483-1
  42. Nsiah K., Shang V.O., Boateng K.A., Mensah F.O. Prevalence of metabolic syndrome in type 2 diabetes mellitus pa-tients. Int J. Appl. Basic. Med. Res., 2015, vol. 5, no. 2, pp. 133–138. DOI: 10.4103/2229-516X.157170
  43. Drapkina O.M., Chaperkina S.O. Interrelation of metabolic syndrome, aseptic inflammation and endothelial dysfunc-tion. Rossiiskie meditsinskie vesti, 2007, vol. 12, no. 3, pp. 67–76 (in Russian).
  44. Lee Y., Huxley R.R., Wildman R.P., Woodward M. Indices of abdominal obesity are better discriminators of cardio-vascular risk factors than BMi: a meta-analysis. Journal of Clinical epidemiology, 2008, vol. 61, no. 7, pp. 646–653. DOI: 10.1016/j.jclinepi.2007.08.012
  45. Shimizu Y., Kodama K., Nishi N., Kasagi F., Suyama A., Soda M., Grant E.J., Sugiyama H. [et al.]. Radiation expo-sure and circulatory disease risk: Hiroshima and Nagasaki atomic bomb survivor data, 1950–2003. BMJ, 2010, vol. 340, pp. b5349. DOI: 10.1136/bmj.b5349
  46. Yamada M., Wong F.L., Fujiwara S., Akahoshi M., Suzuki G. Noncancer disease incidence in atomic bomb survivors, 1958–1998. Radiat. Res., 2004, vol. 161, no. 6, pp. 622–632. DOI: 10.1667/RR3183
  47. Ivanov V.K., Maksyutov M.A., Chekin S.Y., Petrov A.V., Biryukov A.P., Kruglova Z.G., Matyash V.A., Tsyb A.F. [et al.]. The risk of radiation-induced cerebrovascular disease in Chernobyl emergency workers. Health Phys, 2006, vol. 90, no. 3, pp. 199–207. DOI: 10.1097/01.HP.0000175835.31663.ea
  48. Takahashi I., Shimizu Y., Grant E.J., Cologne J., Ozasa K., Kodama K. Heart Disease Mortality in the Life Span Study, 1950–2008. Radiat Res., 2017, vol. 187, no. 3, pp. 319–332. DOI: 10.1667/RR14347.1
  49. Ivanov V.K., Chekin S.Yu., Maksyutov M.A., Kashcheev V.V., Karpenko S.V., Tumanov K.A., Korelo A.M., Kochergina E.V. [et al.]. Radiation Risk of Incidence of Hypertensia among Russian Recovery Operation Workers of the Chernobyl Accident. Meditsinskaya radiologiya i radiatsionnaya bezopasnost', 2017, vol. 62, no. 1, pp. 32–37 (in Russian). DOI: 10.12737/25050
  50. Sasaki H., Wong F.L., Yamada M., Kodama K. The effects of aging and radiation exposure on blood pressure levels of atomic bomb survivors. J. Clin. Epidemiol., 2002, vol. 55, no. 10, pp. 974–981. DOI: 10.1016/S0895-4356(02)004390
Received: 
10.06.2019
Accepted: 
01.12.2019
Published: 
30.12.2019

You are here

Home